When Dave Duerson killed himself at his Florida beachfront condominium in February 2011, he shot himself through the heart, not the head.

A member of the feared Chicago Bears Super Bowl-winning team of 1985-86, a savage hitter on the best defence the game has seen, Duerson wanted to leave a message from beyond the grave. He wanted scientists to study what had happened to his brain. He was 50.

When Junior Seau, another of the best players in NFL history, a fearsome competitor renowned for his ability to play through pain, killed himself at his house in Oceanside, California, a year later, he also shot himself in the heart. Seau did not leave a suicide note but some scribbled lyrics from one of his favourite songs were found near his body. The song was called ‘Who I Ain’t’. He was 43.

Dylan Hartley was knocked unconscious in England's Grand Slam-winning match at the Stade de France

Seau claimed never to have suffered a concussion in his 20-year playing career but everyone knew long before his family donated his brain tissue to the National Institutes of Health (NIH) that simply wasn’t true.

When the NIH released their findings, they showed that Seau’s brain exhibited definitive signs of Chronic Traumatic Encephalopathy (CTE), a degenerative brain condition caused by repeated blows to the skull. Duerson’s results were the same.

CTE is the most feared acronym in professional sport these days. It is cutting down NFL veterans like machine-gun fire, coming for them in their early middle age when they are still in the after-glow of their careers, striking them down with depression, leaving big gaps in their short-term memory, causing forgetfulness and irritability, acting as the precursor for dementia.

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CTE can only be detected after death and sport has tried to pretend it didn’t exist. Or, if it did, that it was nothing to do with a playing career. Then, a fortnight ago, for the first time, the NFL admitted that there was a link between gridiron-related head trauma and the brain disease.

A few days ago, Sports Illustrated magazine carried an interview with former Jacksonville and Baltimore guard Will Rackley, who retired in 2014 at the age of 24 after four seasons and a series of concussions. Rackley, SI reported, ‘takes 12 pills a day to deal with the headaches and mood swings and depression and short-term memory loss and sensitivity to light and noise and on and on’. His is a familiar story.

America is no longer in denial about the terrible effects repeated head injuries suffered in sporting contests can have on a competitor’s life but in Britain, sadly, things are different. Sport in this country pays lip service to concussion protocols but rugby and football sometimes treat them as inconveniences that must be observed to indulge the politically correct.

England captain Hartley was carried off only to return after the match to lift the Six Nations trophy

England coach Eddie Jones is not alone in having an outmoded attitude. ‘The great thing about head injuries is that they are a simple medical issue,’ he said last week. The truth is that they are about as far from simple as it is possible to be.

Some progress is being made: in football, Newcastle forward Aleksandar Mitrovic suffered a head injury against Sunderland and then angrily demanded to be allowed to play on. Newcastle’s doctor, Paul Catterson, refused.

Still, a report released last week by the 2014 Professional Rugby Injury Surveillance Project revealed that concussion remains the most common injury in English professional rugby, accounting for 17 per cent of reported injuries. Many modern elite players are behemoths, trained to collide to make a few yards at the gain line. Physique and rugby culture are two of the reasons why concussion is so prevalent.

Newcastle striker Aleksandar Mitrovic suffered a head injury during match against Sunderland

When Dylan Hartley was knocked unconscious in England’s Grand Slam-winning match at the Stade de France, the skipper was carried off only to return after the match to lift the Six Nations trophy. Days later, it was reported with a mixture of amusement and admiration that Hartley could not remember holding the cup aloft.

And yet, there was discussion about whether he would play for Northampton against Harlequins today. It was absurd. Hartley will not play, but it should never have even been a remote possibility.

Being knocked out and coming back on to the pitch to finish the game is still seen as a badge of honour for many rugby players. It is like being a smoker in your 20s and someone telling you those cigarettes are going to kill you when you get to 70. Who cares? It feels as if it is a long way away.

Mitrovic angrily demanded to be allowed to play on in the derby but the Newcastle doctor refused

Despite a growing scientific consensus, despite the excellent work done by journalists like my colleague Sam Peters and The Mail on Sunday’s Concussion Campaign, we are still not worried enough about players like George North and Jonny Sexton suffering repeated head injuries to do anything about it.

STYLE AND SUBSTANCE

Johan Cruyff was a hero of mine. Most of all, I loved him for the way he played, but it was about what he stood for, too.

It was his grace and his style on the pitch, but it was also his independence of thought. He could be cussed and argumentative and he was undoubtedly one of the game’s great thinkers.

He was unapologetic about seeing football as art and that, as much as the beauty of his football, lifted him into a different dimension.

Last year, North suffered four head blows in five months. Sure, he, Hartley, Sexton and others are forced out of the game for a few weeks, perhaps even months, if it happens to them often enough — which it has — but then they go back for more. The damage keeps on happening. Who knows when they will reach the point of no return? Or if they have passed it already.

It sounds alarming, doesn’t it? That’s because it is. You can scream ‘political correctness’ and ‘nanny state’ all you want and you can lampoon the concerns of doctors and health experts about school rugby by drawing cartoons of kids going out to play wrapped up like the Michelin Man. But in the end, there will be a reckoning.

If nothing is done, if measures are not taken to arrest the incidence of concussion in rugby, if more questions are not asked about safeguarding victims, then people will pay.

You can be sure it won’t be those who mock the concerns about player welfare. They’ll be just fine. But the players? The ones who have been repeatedly concussed? One day, they will find the darkness starting to crowd in.

Serena a star in game of equals

Justine Henin-Hardenne's tussle with Serena Williams at the 2003 French Open was intense

QUESTION TIME

A vignette from England’s Friday press conference in Berlin.

Gary Cahill is asked a question about whether Gary Neville’s standing with the players has been affected by his struggles at Valencia.

The communications officer says Cahill’s not going to comment.

‘Oh, let him answer,’ says Roy Hodgson. ‘This is a democracy, a bit of free speech is OK.’ Everyone then turns to Cahill. ‘I don’t want to comment,’ he says.

It seems strange that Novak Djokovic and others resent the fact women are paid equal prize money to men at some tennis events.

I thought it was only dinosaurs that were still trying to fight that battle. If men and women are playing alongside each other at an event, if the public are paying to watch them both, then they should be paid equally.

Apart from any Roger Federer match, the best tennis I’ve seen for quality, atmosphere and intensity was Justine Henin-Hardenne v Serena Williams in the 2003 French Open semi-finals.